Waikato Institute of Technology

Climate change is affecting ecosystems worldwide. Ocean temperature is increasing, leading to more frequent and intense extreme weather events such as heatwaves (HWs) and marine heatwaves (MHWs). These extreme temperature events can affect marine biodiversity, the relative success of different life history strategies, and the structure and function of whole ecological communities. Understanding the effects of HWs on marine communities and the mechanisms that enable marine communities to resist and recover from heat stress has become a research priority. Here, we investigated the effects of a simulated HW on macrobenthic communities and their functional traits in intertidal estuarine sediments using a novel in-situ seafloor warming experiment with two heatwave duration treatments. Our results revealed that the simulated HW influenced macrobenthic abundance and diversity, yet, functional traits and functional metrics were less affected. This suggests resilience to the simulated HW related to redundancy of macrobenthic functional traits. The idiosyncratic responses observed in our study reflects the complex and context-dependent macrobenthic responses to thermal extremes. Our findings suggest that maintaining functional trait diversity and redundancy could be key for boosting ecosystem resilience under increasing climatic extremes.

Abstract This research demonstrates that improving the characterization of Polyhydroxy butyrate (PHB) with 20 wt% Polycaprolactone (PCL), 5 wt% mixed Plasticizer (i.e., monomeric plasticiser (Triacetin 99%) and Polymeric plasticiser (Ultramoll IV), and nanomaterials, i.e., 1 wt% nanocellulose and 6 wt% nano clay, can improve the PHB characteristics for packaging purpose. Biodegradable polymer films were developed using injection moulding and hot-pressing methods, and characterised by tensile properties, water vapor barrier properties, and biodegradation properties in compost and seawater medium. The properties of the nanocomposite films compared to plasticised PHB-PCL 20 films show improved tensile strength, water vapour barrier properties, and slightly higher biodegradation rate with nanomaterials, though with reduced elongation at break. The nanocomposite films were also compared to neat PHB, with 1% nanocellulose (nCell) and 6% nano clay (nClay) providing higher tensile elongation (168% & 146% higher), higher water vapor barrier properties / Lower water vapor transmission rate (46% & 58% lower), and higher biodegradation in home compost (13 % & 11% higher) and seawater medium (10% & 11% higher). The research outcome shows that the high-performance PHB nanocomposite blend with 1% nanocellulose and 6% nano clay.

Australian and New Zealand osteopaths predominantly manage musculoskeletal complaints using a variety of modalities including manual therapy, exercise and lifestyle and occupational advice. There appears to be a small percentage of patients who seek osteopathy care for non-musculoskeletal issues such as conditions affecting the gastrointestinal tract. The evidence base for osteopathic treatment as part of the management of such conditions is equivocal. The aim of this study was to describe the practice of Australian and New Zealand osteopaths who report often treating patients with non-musculoskeletal complaints. This study is a secondary analysis of data from the Australian and New Zealand osteopathy practice-based research networks (PBRNs) collected in Australia from July to December 2016 and in New Zealand from August to December 2018. Respondents to the PBRN baseline surveys were asked to provide information about their demographic, patient and clinical management characteristics. One of these characteristics was the frequency of treating patients presenting with non-musculoskeletal complaints. Descriptive and inferential statistics were used to inform regression modelling of significant predictors of often managing non-musculoskeletal complaints. Of the 1254 osteopath participants from Australia and NZ, 13.5% (n = 170) reported often treating patients presenting with non-MSK complaints. Significant predictors of often treating patients presenting with non-MSK complaints were often using visceral (ORa 3.54 95%CI 2.15-5.85) and Osteopathy in the Cranial Field (OCF) (ORa 2.05 95%CI 1.20-3.51) techniques, and often treating patients up to the age of 3 years (ORa 3.05 95%CI 1.89-4.90). More than one in ten Australian and New Zealand osteopaths report often treating patients presenting with non-MSK complaints, with the dominant manual therapy approaches used being visceral techniques and OCF. This study provides a unique insight into the characteristics of osteopaths who often treat patients presenting with non-MSK complaints. Further research is required to examine if patients seek out care from an osteopath specifically for non-MSK complaints or primarily seek out care from an osteopath for MSK complaints but are managed for non-MSK complaints as a secondary consideration.

Worldwide, mothers experience physical postpartum symptoms affecting their quality of life, such as perineal pain, urinary incontinence, faecal incontinence, pelvic girdle pain, and dyspareunia. However, the experience of postpartum recovery in New Zealand is poorly understood. The primary objective of this study was to explore the views of postpartum mothers, midwives, and pelvic and women’s health physiotherapists regarding physical postpartum symptoms. The secondary objective was to investigate perceptions of the response of New Zealand’s funded maternity services, including access to pelvic and women’s health physiotherapy. Fifteen participants completed a semi-structured interview: five mothers in the first postpartum year, five midwives, and five pelvic and women’s health physiotherapists. Through thematic analysis, five key themes were identified: (a) beliefs about the postpartum period; (b) the “knock-on” effect; (c), the current maternity model; (d) belief that pelvic and women’s health physiotherapy can help; and (e) barriers and facilitators to pelvic and women’s health physiotherapy. Physical postpartum symptoms were seen to limit daily activities and have psychological ramifications for mothers. Participants felt that there is limited support for mothers’ physical symptoms under New Zealand’s funded maternity services. Pelvic and women’s health physiotherapy was perceived as a beneficial service for postpartum rehabilitation; however, several perceived barriers to this service were noted, including cost, a lack of knowledge, and difficulty navigating the healthcare system. Greater contributions are desired for mothers’ physical symptoms under the current maternity model of care, including more funding, education initiatives, and improved referral methods.

This research focuses on optimizing the response consistency of Large Language Models (LLMs) in medical education through advanced prompt engineering techniques. LLMs often give different answers to the same question, making self-consistency a critical parameter for assessing their performance. Addressing this inconsistency is essential in high-stakes fields like healthcare, where reliable and accurate information is important. The study employed custom prompt engineering strategies, including zero-shot, few-shot, and Chain-of-Thought (CoT) prompting, to improve LLM output consistency and accuracy. We implemented a retrieval-augmented generation (RAG) framework to use external knowledge from trusted medical resources, keeping the responses accurate and contextually appropriate. Responses were scored on several dimensions: content relevance, completeness, and clinical correctness, and assessed for consistency by asking repeated queries. The results showed significant enhancement in the consistency and accuracy of the responses, proving the effectiveness of the presented method. This work outlines suggestions for the use of LLMs in a way that can be incorporated into medical education while considering the limitations. It underscores the need for further exploration of prompt engineering to improve LLM performance and establishes these tools as reliable resources for training healthcare professionals.

Background: Residual interlimb deficits after anterior cruciate ligament reconstruction (ACLR) can lead to functional maladaptation and increase the risk of reinjury. The tuck jump assessment (TJA) may offer a more effective evaluation of ACLR status as compared with traditional tasks owing to increased risk of altered landing mechanics, asymmetrical landing, and increased knee valgus attributed to the cyclical nature of the task. However, it remains unclear whether altered TJA kinetics resolve over time or persist through return-to-play phases of rehabilitation. Purpose: To examine longitudinal kinetics, asymmetries, and functional performance deficits during TJA at 9 and 12 months after ACLR in female athletes at high risk of reinjury. Study Design: Cohort study; Level of evidence, 2. Methods: Female athletes (ACLR, n = 24; controls, n = 19; total, N = 43) performed a single trial of TJA on dual-force plates at 2 time points. The ACLR group (mean ± SD age, 16.8 ± 1.9 years) was tested at 9 and 12 months after surgery, and the control group (16.5 ± 3.6 years) was tested at similar time points. All athletes participated in similar sports and had comparable activity levels. Discrete time point analysis and statistical parametric mapping were used to identify deficits within each group. Results: At 9 months after surgery, the ACLR group exhibited significant interlimb differences in all kinetic variables (P < .05), which persisted at 12 months with only small reductions in magnitude. As compared with controls, the ACLR group demonstrated a persistent offloading strategy in the involved limb by exhibiting larger interlimb asymmetries for a range of kinetic variables and a greater vertical ground-reaction force in the uninvolved limb during most of the stance phase at both time points (P < .001). Distinct differences in functional performance of TJA were evident at both time points, characterized by lower peak vertical ground-reaction force, peak center of mass displacement, and relative vertical leg stiffness and longer ground contact times (P < .001). Conclusion: This study revealed that young female athletes after ACLR exhibit persistent interlimb deficits and functional maladaptations up to 12 months after surgery. The TJA identified significant biomechanical impairments to both limbs, resulting in asymmetrical loading and altered movement strategies as compared with healthy controls. Despite some improvements, athletes with ACLR continued to demonstrate offloading to the uninvolved limb, indicating incomplete neuromuscular recovery.

Purpose: Constraint-induced movement therapy (CIMT) is an evidence-based intervention for arm recovery after acquired brain injury. Clinician knowledge, time and confidence in delivering CIMT are established barriers to the routine use of CIMT in practice. CIMT delivery via telehealth is one option to help overcome these barriers. This study aimed to understand clinician experiences of using an educational website and if the education and online resources contributed to their self-reported use of constraint-induced movement therapy via telehealth (TeleCIMT) in practice. Materials and Methods: Data were collected from a purposive sample of therapists registered to use the TeleCIMT website and website analytics. An online survey explored participants' experience with CIMT delivery (both face to face and via telehealth), their perceptions of the website, and barriers and enablers to TeleCIMT implementation using the Capability, Opportunity, Motivation-Behaviour model. Website analytics were used to evaluate website traffic and resource use. Data were analysed using descriptive statistics (quantitative data) and content analysis (qualitative data). Results: Forty therapists responded to the survey; 72.5% (n = 29) of the respondents were occupational therapists, and 37.5% (n = 15) had delivered TeleCIMT. Most of the participants agreed that the website was easy to navigate (n = 26, 90%) and felt that they had the knowledge (n = 28, 96.6%) and skills (n = 24, 82.7%) to deliver TeleCIMT. The enablers to TeleCIMT included motivation to implement learnings from the website, confidence in delivering the programme, and the convenience of remote delivery. The perceived barriers to TeleCIMT use included limited access to technology and the availability of a client supporter to enable engagement in TeleCIMT. The resources used most frequently by the respondents were the participant preparation pack and participant programme pack. Shorter video learning modules (<11 min in duration) had greater engagement than longer video learning modules. Conclusions: Whilst online education and resources may enhance clinician knowledge of constraint-induced movement therapy and telehealth delivery, other barriers such as lack of technology access, may need to be addressed through additional learning and implementation strategies to support the routine use of TeleCIMT in practice.

Abstract Early diagnosis of cardiovascular diseases (CVDs) is critical to target treatments that reduce CVD mortality. Improving the accuracy of early diagnostic tools is, therefore, a key goal for biomedical scientists and engineers. Arterial stenosis is one form of CVD for which effective, non-invasive early diagnosis is invaluable. Current studies concerning the computational and numerical assessment of stenosis indicators use different mathematical models, such as laminar and k-omega shear stress transport (SST) models. These models are available in several software packages, such as ANSYS (Fluent and CFX), OpenFOAM, and COMSOL. These packages allow the users to set different boundary conditions, such as velocity at the inlet and pressure at the outlet and create user-defined functions (UDFs) with different expressions and constant values. However, there currently needs to be a rule over what to impose at these boundaries. Furthermore, previous studies have used various assumptions, such as rigid artery wall, one-way fluid-structure interaction (FSI) or two-way FSI, and the blood’s Newtonian or non-Newtonian material properties. This variety in construction has associated deviations of the models from the clinical data and lessens the value of the models as potential diagnostic or predictive tools for medical practitioners. In this study, we examine stenosis of increasing severity, presenting first a healthy artery and then three arteries with stenosis of 20%, 40% and 50%, analysing in terms of the strain energy to the artery wall based on the propagated waveforms through the arteries under the different arterial diameters. Many current studies use rigid walls and zero pressure boundary conditions at the outlet using a laminar or k-omega SST model. In this study, we investigate elastic walls using the one-way FSI concept and the pressure waveform at the outlet, comparing the results across the two common methods of laminar and k-omega SST. These velocity and pressure waveforms are provided as an expression based on clinical data. The results regarding the strain energy (mJ) behaviour along the artery wall show that the k-omega SST model outperforms the laminar model for short arterial segments and under the Newtonian assumption with a no-slip boundary wall and turbulent flow.

Abstract Early diagnosis of cardiovascular diseases (CVDs), including arterial stenosis, enables targeted treatments that reduce CVD mortality. It is vital to improve the accuracy of early diagnostic tools. Current computational studies of stenosis use mathematical models, such as laminar and k–omega shear stress transport (SST) models, available in ansys (Fluent and CFX), openfoam, and comsol software packages. Users can adjust boundary conditions, such as inlet velocity and outlet pressure using user-defined functions (UDFs) with different expressions and constant values. However, currently there is no rule over what to impose at these boundaries, and previous studies have used various assumptions, such as rigid artery wall, one-way fluid–structure interaction (FSI) or two-way FSI, and the blood's Newtonian or non-Newtonian material properties. This variety in construction has associated deviations of the models from the clinical data and lessens the value of the models as potential diagnostic or predictive tools for medical practitioners. In this study, we examine arterial stenosis models, with severities of 20%, 40%, and 50%, compared with the healthy artery analyzed in terms of strain energy to the artery wall. Additionally, we investigate elastic walls using one-way FSI, comparing with laminar and k–omega SST. These boundary conditions are based on clinical data. The results regarding the strain energy (mJ) behavior along the artery wall show that the k–omega SST model outperforms the laminar model for short arterial segments and under the Newtonian assumption with a no-slip boundary wall and turbulent flow.